Analysis on Clinical Risk Factors of Brain Injury Diagnosed by MRI in Preterm Infants

XU Hong-tao; NIE Guo-ming; ZOU Min-shu; YU Jian; DING Dong-sheng; YIN Tai-yong; LI Jing

doi:10.13730/j.issn.1009-2595.2017.06.008

Abstract：Objective To discuss clinical risk factors of brain injury in preterm infants and the application value of magnetic resonance imaging (MRI) in diagnosis of brain injury.Methods MRI and clinic data were collected among preterm infants with gestational age <37 weeks, who were admitted to neonatal intensive care unit (NICU) in authors, hospital from October 2014 to March 2016.McNemar test was adopted to compare the sensitivity of MRI plain scan imagings: T1 weighted image (T1WI), T2 weighted image (T2WI) and diffusion-weighted imaging (DWI) for diagnosis of hypoxic ischemic brain injury.The incidences of brain injury in different gestational age of preterm infants were compared by X2 test.Clinic correlation factors on brain injury were explored with logistic regression analysis.Results The sensitivity in diagnosis of hypoxic ischemic brain injury by DWI sequence was significantly higher than that by T1WI or T2WI (P<0.05).The total incidence of brain injury was 23.66%.Gestational age of 28 less than 32 weeks preterm infants were significantly higher than gestational age of 32 less than 34 weeks and 34 less than 37 weeks (P<0.01).There was significantly different in the incidence of periventricular-intraventricular hemorrhage among all brain injury types of preterm infants with different gestational age (P<0.01).Mechanic ventilation, resuscitation, hyponatremia and vaginal delivery were risk factors of hemorrhagic brain injury.Low Appgar scores (5 scores), gestational infection and gestational diabetes mellitus were risk factors of hypoxic ischemic brain injury.Conclusion T1WI-T2WI combine with DWI sequence can increase the positive rate of detecting brain injury in preterm infants.Preterm infants with vaginal delivery, resuscitation, mechanic ventilation and hyponatremia have more risks of cerebral hemorrhage, and those with mother's ante partum infection, gestational diabetes mellitus and hypoxia have more risk of hypoxic ischemic brain injury.